Minorities May Be at Higher Risk for Diabetes and Heart Disease

A recent analysis funded mostly by the National Institutes of Health found that United States minorities may have a higher risk for heart attacks even at a normal weight.

Researchers looked into the relationship between cardiometabolic disease and body weight in normal-weight adults of 5 different racial/ethnic groups. They sought to find out how common it was for normal-weight people of certain racial or ethnic groups to suffer from metabolic abnormality.

A cross-sectional analysis of 2 community-based groups was conducted. The participants involved 2,622 whites, 803 Chinese Americans, 1,893 African Americans, and 1,496 Hispanic persons from MESA (Multi-Ethnic Study of Atherosclerosis) and 803 South Asians from the MASALA (Mediators of Atherosclerosis in South Asians Living in America) study.

The researchers estimated 2 or more “cardiometabolic abnormalities” in the normal-weight participants such as high fasting glucose, low HDL cholesterol, high triglycerides, and high blood pressure.

What Race/Ethnicity is Most at Risk?

Metabolic abnormalities in these normal weight adults were reported as following: 21 percent in whites, 32 percent in Chinese Americans, 31 percent in African Americans, 38.5 percent in Hispanics, and 43.6 percent in South Asians.

The researchers adjusted for demographic, behavior, and even ectopic body fat measures and this didn’t explain the differences they found. Then they adjusted for the factors of age, sex, and race/ethnicity-body mass index interaction for the equivalent metabolic abnormalities in normal weight prevalence at a BMI of 25.0 kg/m2 in whites.

The corresponding BMI values at which metabolic abnormalities would be seen were 22.9 kg/m2 in African Americans, 21.5 kg/m2 in Hispanics, 20.9 kg/m2 in Chinese Americans, and 19.6 kg/m2 in South Asians.

This means that while problems like high blood pressure and high fasting blood sugar levels are seen in whites once BMI levels are around 25 kg/m2, these cardiometabolic issues may be happening at lower weights for minorities with the most dramatic differences observed in South Asians.

Why Does This Matter?

The reason these study results matter is because screening for things like blood sugar and cholesterol levels is often done based on a person’s calculated BMI from their weight at a healthcare visit. However, if they are likely to have cardiometabolic problems before the current “overweight” BMI figure then screening for a patient may not take place until their health worsens.

When diabetes or high cholesterol is caught later rather then sooner, it is then a more costly situation from a healthcare standpoint as well as the patient’s quality of life.

Researchers concluded that in comparison with whites in the United States, minorities of different race/ethnicities may have a higher risk for diabetes and heart disease and that “Using a BMI criterion for overweight to screen for cardiometabolic risk may result in a large proportion of racial/ethnic minority groups being overlooked.”

Things to Remember About Your BMI

If you are concerned that you carry too much weight, especially in the belly area despite a “normal” range BMI or weight, it may be useful to talk to your healthcare provider about being screened for various cardiometabolic issues like high blood sugar or high blood pressure.

Also, it is important to take note that BMI, while useful, cannot accurately measure the amount of fat someone may carry. Someone who lifts weights may have a higher BMI and someone who is very inactive but relatively lean can carry a surprising amount of body fat. One must also take into account overall frame–whether small, medium, or large. A small frame can carry more fat before weight and BMI levels fall under “overweight” status.

Sysy Morales is a staff writer and editor at Diabetes Daily and has lived with type 1 diabetes for 24 years. She has led dozens of diabetes education and motivational programs across the country and is a graduate of The Institute for Integrative Nutrition. Sysy started blogging about diabetes at The Girls Guide to Diabetes after the birth of her twins to share how she maintained recommended A1C levels during that time. What she has learned about diabetes dramatically improved her life and she is now obsessed with sharing information that may help other people with diabetes thrive, too. At the end of 2018, her daughter was also diagnosed with type 1 diabetes.